Media Consent Form for CROA Event: How Kicking is your CICC?

For completion by CICC Adult Supporter

At How Kicking is your CICC? we will be taking photos and recording video interviews in order to capture the things everyone is doing and talking about at the event. We then intend to share them online using CROA’s Blip.tv account so that CICC members who aren’t able to attend can benefit from the day’s learning and everyone can use them to improve their CICC.

Please can you complete and return this form by email to joe@croa.org.uk, even if no consent is given.

Name of Children in Care Council: _________________________________

Name of Adult Supporter: ______________________________________________

Name/s of young people attending How Kicking is your CICC?:

I confirm/do not confirm that ______________________ (name of first attendee) has consented and (if under 18) that their parent, guardian or other person with responsibility for them has also consented, to photos or video footage taken of them at the event being included in trusted online media.

I confirm/do not confirm that ______________________ (name of second attendee) has consented and (if under 18) that their parent, guardian or other person with responsibility for them has consented, to photos or video footage taken of them at the event being included in trusted online media.

Signed (electronic signature ok if sent via signatory’s email account)

NB Please note that we will be supplying badges for anyone who does not wish to appear on film or in photos produced during the event. If they are captured on film then they will either be edited out or the footage will not be used.